Individual
DR. BRUCE ALLEN MAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 271-5367
(352) 271-5385
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 271-5367
(352) 271-5385
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME70205
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377560700
—
FL
01
—
68747
BCBS FL
FL
01
—
CI6613
RAILROAD MEDIARE
FL
Enumeration date
06/21/2006
Last updated
01/04/2011
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